FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 1 

### NIOSH Fire Fighter Fatality Investigation and Prevention Program **(FFFIPP) Progress**  **Report and Proposed Future Directions** 

**– 20**  **1 4**  The National Institute for Occupational Safety and Health (NIOSH) is committed to ensuring that the NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) is meeting the needs and expectations of the U.S. fire service. NIOSH has sought public input to help plan and direct the goals and objectives of the FFFIPP since the program was initiated in 1998. NIOSH re ceived public comments on the FFFIPP in January 1998, March 2006, November 2008 , and August of 2011

. Records of previous public comment periods are available at: http://www.cdc.gov/niosh/fire/programreview.html

. In 2011, 26 comments were received from a variety of sources. This included 1 4 fire departments , 4 private individuals, 4 professional organizations, 2 colleges or universities, and 2 Federal agencies. These comments are available at: http://www.cdc.gov/niosh/docket/archive/docket063B.html

. The primary

modifications made to the FFFIPP following the August 2011 stakeholder comments are as follows: T he FFFIPP is more attentive to selecting reviewers that have experience and expertise matched to the event circumstances of an investigation; i n c ases where highl y specialized issues are identified as contributing factors, external fire service subject matter experts are consulted to assist during the investigation ; and the FFFIPP is working closel y with the N ational V olunteer F ire C ouncil in conduct ing volunteer fire department fatality

investigation s and in obtaining reviewers for incidents involving volunteer fire d epartments

. NI OSH is again seeking stakeholder input on the progress and future direction s of the NI OSH FFFIPP to ensure that the program is meeting the needs and expectations of the U.S. fire service, and to identify way s in which the program can be improved to increase its impact on the safety and health of fire fighters across the United States

.
**Background** During fiscal ye ar 1998, Congress identified the need to address the continuing national problem of occupational fire fighter fatalities and fun ded NI OSH to implement a fire fighter safety

initiative. In response to stakeholder s , the FFFIPP conducts independent investigations of fire fighter line

- of

- duty deaths (LODD) and formulate s recommendations for preventing deaths and injuries.
Since the F FFIPP was initiated, 1,983 fire fighters have died in the line

- of

- duty through 201 3 (not counting the 343 fire fighters who died on September 11, 2001). During this period the FFFIPP investigated 644 fire fighter LODDs or 3 2 percent of the total ( 36 8 trauma and 2 76 medical LODDs).FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 2 **Investigation Priorities** Since NIOSH does not have the resources to conduct investigations of all fire fighter LODDs, each incident is prioritized using a decision logic that can be found on the NI OSH FFFIPP website at http://www.cdc.gov/niosh/fire/pdfs/FFFIP_DecisionChart.pdf

. The current priorities for investigating traumatic LODDs include multiple fatality events, structure fires, motor vehicle incid ents, and new or emerging hazards. The priorities for investigating medical LODDs include hyper/h ypothermia; seizures, diabetes, and drug overdose; sudden cardiac death during phy sical fitness training; sudden cardiac death during emergency

responder trai ning ; and sudden cardiac death on the fireground

. NI OSH welcomes comments on these priorities along with suggestions for replacing or modifying them. **Program Accomplishments**
From January 20 11 through April 30, 2014 , the FFFIPP has accomplished the fo llowing:

 Completed

– 4 8 medical and 4 7 traumatic injury investigations ;

 Published

– NI OSH Workplace Solutions: Preventing Deaths and Injuries of Fire Fighters Operating Modified Excess/Surplus Vehicles. DHHS (NIOSH) Publication N o. 2011

- 125 ;

 Published

– NI OSH Workplace Solutions: Preventing Deaths and Injuries to Fire Fighters by Establishing Collapse Zones at Structure Fires

. DHHS (NIOSH) Publication No. 2014

- 12 0;

 Published

– Estes CR, SM Marsh and DN Castillo (2011). Surveillance of Traumatic Firefi ghter Fatalities: An Assessment of Four S ys tems. Pub Health Rep 126(4):540

- 51 ;

 Released

– Fire Fighter Fatality Map Application on the NIOSH website

. Available at http://wwwn.cdc.gov/wisards/fffmap/ ;

 P rovided information and data from a series of LODD investigations regarding the thermal degradation of S elf

- C ontained B reathing Apparatus face piece lenses to the N ational F ire P rotection A gency (NFPA) Technical Committee on Respiratory

Protective Equipm ent . This contributed to decisions to raise the temperature requir e ments for heat and flame tests including an additional radiant heat test effective in the 2013 edition of NFPA 1981 Standard on Open

- Circuit Self

- Contained Breathing Apparatus (SCBA) for Emergency Services ;

 Provided information and data from several recent cardiovascular disease ( CVD ) related investigations associated with left ventricular hy pertrophy to the NFPA Technical Committee on Fire Service Occupational Safety and Health ;FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 3  Provide d information and data from heat stroke fatality investigations to the NFPA and the National Wildland Coordinating Group ;

 Provided information and data from a recent training

- related LODD investigation involving an elevated aerial platform to the NFPA Technical Committee on Automotive Fire Apparatus ;

 Provided information and data from recent LODD investigation s involving land mobile radio design and operational issues to the NFPA Technical Committee on Electronic Safety

Equipment . A new standard is curre ntl y being developed entitled NFPA 1802 Standard on Two

- Wa y, Portable (Hand

- held) Land Mobile Radios for Use by Emergency Services Personnel

.

 Provided i nformation and data to NFPA from recent L ODD investigations which supported the revision of NFPA 1561 S tandard on Emergency Services Incident Management System and Command Safety (Effective date: December 2, 2013)

. The standard’s title now includes “Command Safety” and the addition of a new chapter, Command Safety . This chapter will provide a foundation on how to incorporate the incident management s ys tem at all emergency incidents ;

 Provide d i nformation and data to NFPA from recent transportation

- related L ODD investigations which were used to support the pending NFP A 1091 Standard for Traffic Control Incident Management Personnel Professional Qualifications

. F inal approval by the full committee is anticipated in the F all of 2014

.

 Disseminated findings from NIOSH investigations via presentations at multiple fire service and medical conferences.
In additio n, the FFFIPP continues to receive examples of the fire service using program findings and recommendations to improve fire fighter safety. For example:

 D uring 20 11 , 2012, and 201 3 there were a total of 383,952 visits to the FFFIPP webpage ;

 Fire departments regularly report using FFFIPP investigation reports and publications to support fire fighter training and during promotional examinations ;

 The 2012 International Residential Code requires the application of a dry wall or structural wood membrane to the underside of floor sy stems in non

- sprinkler residential dwellings. The International A ssociation of F ire F ighters (IAFF) proposed this code modification based in part on findings from NIOSH LODD investigations and recommendations that lightweight cons truction sy stems be protected with a fire

- resistant barrier ;

 Fire service publications frequentl y reference and encourage the use of NIOSH fatality investigation reports and recommendations to improv e fire fighter safety.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 4 **Strategic Plan**
Since 2009 , the S trategic Plan for the NI OSH FFFIPP has been used to guide the research and continued implementation of the program (available at http://www.cdc.gov/niosh/fire/strategicplan2009.html )

. Th e Strategic P lan addresses the mission of the FFFIPP, strategic goals to improve fire fighter health and safety , program activity /output goals , and performance measures by which the program can be evaluate d

. **Progress Toward**  **Goal Achiev**  **ement**
The f ollowin g table summarizes the FFFIPP implementation progress since January 2011 related to individual activity /output goals and performance measures in the Strategic Plan

.
**FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments**  **Goal A: Conduct fatality investigations**  **as the principal activity of the FFFIPP**  95 fatality investigations completed ( 4 8 medical and 4 7 traumatic ) NI OSH proposes that LODD investigations remain the highest FFFIPP priority A.1: Investigations will be finalized each ye ar at a minimum of 3 investigations per fulltime investigator. 8 investigators ( 7 fulltime and 1 half

- time ) completed 84 investigations (3 per investigator per ye ar for traumatic and 10 per investigator per ye ar fo r medical ) The program is currentl y st a ffed with 7 fulltime investigators, 5 assigned to traumatic investigations

.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 5 **FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments** 
A.2: 90% of i nvestigations through 201 3 will involve CVD s , structure fires, or motor vehicle accidents ( MVA ) incidents. 85 % of all cases i nvolved CVD s , structure fires, or MVA incidents

. The goal of 90% of investigations involving CVDs, structure fires, or motor vehicles was not met because of NI OSH investigating several incidents involving other serious medical conditions (e.g., heat stroke ) and unique trauma events (e.g., training related fatalities, explosions) at the request of the fire service

. A.3 : Initial site visit s will be conducted within 3 weeks of the fatality in 80% of fatal traumatic injury incidents

. Site visit s were conduc ted for 6 3 % of traumatic injury incidents within 3 weeks. Site visits are often delayed at the request of the fire department, in d eference to f

uneral and memorial services A.4: Input will be obtained to improve the design and format of fatality inves tigation reports by Fiscal Year 2010. Report format revisions were implemented during 2009 and 2010. NI OSH continues to welcome stakeholder comment on reports to improve their utility to the fire service. A.5: Investigation priorities will be revisite d and input sought for proposed changes b y 2010. Stakeholder input from the 2011 docket is being addressed

. CVDs, structure fires, and motor vehicle incidents continue to be leading causes of LODD in the fire service

.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 6 **FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments** 
**Goal B: Individual fatality**  **reports will be generated for**  **each investigation and investigation**  **findings will be reported and summarized in**  **additional publications.** A report is completed for each investigation and additional NI OSH publications are developed as issues are identified

. The Program will continue produc ing LODD reports and NI OSH publications , such as the recentl y release d Workplace Solutions document on building collapse zones. B.1: 50% of investigation report s will be completed within 6 m onths of the site visit , 95% will be w i thin 12 months. 41 % of the i nvestigation reports we re completed within 6 months and 75 % were completed within 12 months

. The Program will continue efforts to reduce the completion time for investigations

. In cidents involving larger departments, multipl e fatalities, criminal charges, and delays in autopsy reports frequentl y result in longer completion times. B.2: O ne document (other than a fatality report) will be published annually NI OSH Workplace Solution s were published in 2011 and 2014

. While N IO SH has not release d at least one such document annually , several new documents are in various stages of development. **Goal C: Seek peer and stakeholder input to improve the**  **quality of products and the impact of the program.**  C.1: 75% of traumatic f

atality reports will be reviewed by external experts and 100% of publications will be reviewed b y peer s and/or stakeholder s 100 % of traumatic LODD reports were reviewed by one or more external fire service subject matter e xperts . Also, 100% of a ll publications were reviewed by peers and stakeholders

.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 7 **FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments**  C.2.: Expert consultation and/or testing will be sought on all investigations suggestive of personal protective technology malfunctions or failures. External e xpe rt consultation was sought for 4 cases inv olving the possibility

of equipment malfunctions

. NI OSH ’s National Personal Protective Technology Laboratory (NPPTL) assess es P ersonal P rotective E quipment (PPE) and SCBA issues

. C.3: Stakeholder input will be sought at least every

two years through a public meeting and/or docket. NI OSH last received written comments from an open docket in 2011

. NI OSH proposes to seek stakeholder input through public meetings and/or dockets every

five ye ars. **Goal D: Increase fire service expertise of FFFIPP personn**  **el** D.1: Each trauma investigator will take at least one fire service training course or attend a fire service conference specifically for training annually

. Each investigator attended one or more fire service training sessions annually

.

D.2: Announ cements for investigator positions will require fire service and o ccupational safety and health experience. The team includes 4 investigator s with fire service experience
**Goal E: E**  **nsure FFFIPP recommendations and products**  **are used to improve fire figh ter**  **safety and health** E.1: The program will be involved in at least 2 outreach activities annually

. The program activel y support s the National Volunteer Fire Council Safety and Health Week and the International A ssociation of F ire C hief’s Safety , Health, and Survival Week annuall y.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 8 **FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments** 
E.2: FF F IPP investigators will meet annuall y with the National Personal Protective Technology Laboratory (NPPTL) staff to discuss investigation findings related to personal protective technology

. Annual meetings were held to discuss finding s related to personal protective equipment ( PPE ) . FFFIPP and NPPTLroutinel y collaborate on PPE evaluations related to fire fighter LODD s
. NPPT L has established labs at the NI OSH Morgantown site to better support and collaborate with F FFIPP investigators on investigation

related PPE evaluations

. E.3: Investigation findings will be communicated to the National Fire Protection Association (NFPA) and other standards setting agencies annuall y
. FFFIPP and NIOSH staff members participate on 4 NFPA Technical C ommittees. NI OSH documented issues involving land mobile (portable hand held) radios to NFPA by

letter in 2012. FFFIPP staff also p articipated in the IA FF/IAFC Wellness Fitness committee meetings NI OSH proposes continued particip ation on NFPA committees ; however, travel restrictions may

limit NI OSH staff face

- to

face participation in all meetings

.

E.4: Relevant investigation findings will be communicated to PPE manufacturer groups and Certification Organizations as needed, and at least every two ye ars. Findings related to thermal degradation of SCBA lens es and portable radios w ere provided to NFPA

. Manufacturers of fire service equipment , including SCBA and radios are represented on the corresponding NFPA committees. E.5: Imp lement improved communications strategy to reach small and volunteer departments by 2011. FFFIPP team members and the National Volunteer Fire Council (NVFC) have discussed ideas for improving outreach to volunteer departments. NVFC is serving as a liaison to facilitate volunteer department LODD investigations. NI OSH continues to work with NVFC to identify approaches to increase outreach activities with volunteer fire departments in the US. The Division of Safety Research is in the process of hiring a Heal th Communication Fellow which will help to better address this goal in the future.FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 9 **FFFIPP Progress Activity/Output Goal**  **s** Performance Measure s **Progress (** **January 2011**  **t hrou**  **gh April 2014**  **) Comments** 
E.6: Implement i nput from a web publishing consultant to improve the FFFIPP Web site by 2011. Work has not been completed on this effort because the FFFIPP has focus ed on competing priorities

. The Division of Safety Research is in the process of hiring a Health Communication Fellow which will help to better address this goal in the future. E.7: Develop a survey

that would be provided to all departments following a NIOSH fatality investigation that would provide feedback on the investigation and departmental changes made as a result of the investigation will be developed b y Fiscal Year 2011 and implemented b y 2013. A pilot survey was developed and is being pilot tested

. An initial assessment has been completed by

the medical investigation team.

E.8: Seek funding to conduct a study assessing the FFFIPP impact on fire department training, policies and practices by Fiscal Year 2012. Work has not been conducted on this effort because the FFFIPP has focus ed on competing priorities

.
**Proposed Future Directions**
The FFFIPP proposes to continue the emphasis on independent investigation s of fire fighter line

- of

- duty deaths as it first priority . NIOSH participation on stand ard

- setting committees , such as NFPA technical committees , may take a lessor priority, including not attending meeting in person. Attendance at conferences, workshops, training , and fire service stakeholder meetings may be reduced or eliminated. Electronic versions of r eports and publications will continue to be available through the NIOSH and FFFIPP web pages. NIOSH welcomes comments on proposed priorities for the FFFIPP. **Specific Topics for Stakeholder Input in 2014** FFFIPP 2014 Progress Report 1 1 June 2014

FFFIPP Progress Report 10 The NIOSH FFFIPP welcomes comm ents on an y aspect of the FFFIPP. Additionally , s pecific comm ents are being solicited on the following topics:

 FFFIPP priorities for conducting investigations ;

 C hanges to the format of FFFIPP investigation reports ;

 C hanges to the FFFIP P website ;

 Chan ging the frequency of public meeting/docket solicitation for s uggested improvements to the p rogram to five years ;

 E xamples o f how FFFIPP investigation reports and products are used b y fire service organizations, fire departments and fire fighters, and fir e service safety and health researchers ;

 E xamples of FFFIPP impact on fire fighter safety and health ; and

 Whether NIOSH should c ontact a family member of the victim to update them on the NI OSH investigation.